Willingness of in-patients to uptake the vital contributor social health insurance program in a teaching hospital, Southwest Nigeria

Abstract

Background: The introduction of the Vital Contributor Social Health Insurance (SHI) Program in Nigeria was to scale up access to health insurance and achieve universal health coverage. However, many Nigerian in-patients still pay out-of-pocket for health services. This study aimed to determine Nigerian in-patients' willingness to pay for the Vital Contributor SHI Program. Methodology: A cross-sectional analytical study conducted among 133 adult in-patients and care-givers of pediatric in-patients of a tertiary health facility in southwestern Nigeria, not under a health insurance cover, and recruited through a simple random sampling technique. Data were collected using an interviewer-administered questionnaire. Willingness to Pay was assessed using the double contingent valuation by the Bidding method. Descriptive and inferential statistical analysis was performed using the IBM SPSS version 20 with inference made at P > 0.05. Results: Findings showed a low awareness (42.1%) of the National Health Insurance Scheme (NHIS), and much lower awareness of the Vital Contributor Insurance Scheme, (27.1%). A high proportion of the respondents (67.7%) were willing to participate in the scheme, whereas 67.3% of those not willing to participate gave insufficient funds as the reason. The median maximum amount of premium respondents were willing to pay annually was ₦15,000 ($38) and ₦5000 ($12.8) interquartile range. Respondents in the working population (P = 0.032), with some form of education (P = 0.002), having difficulty with paying their medical bills (P = 0.044), who were aware of the Vital Contributor Scheme (P = 0.001) and were knowledgeable about the NHIS benefits (P = 0.026) were significantly more willing to uptake the Vital Contributor SHI Scheme. Conclusion: Although awareness of the Vital Contributor SHI Scheme is low, the proportion of respondents willing to partake in it is satisfying. Increased targeted awareness campaigns should improve uptake. Health management organizations should take the lead in the awareness creation process.